International Classification System Research Articles

Peripapillary retinal thickness and its risk factors in dry-type high myopia

IntroductionTo evaluate the alterations in the peripapillary retinal thickness and its risk factors in dry-type high myopia (HM). MethodsOne hundred and twenty eyes in 69 HM subjects were collected from March 2023 to July 2023 with the age, refractive diopter, axial length (AL), posterior scleral staphyloma, type of myopic maculopathy, and peripapillary retinal thickness. Divided into three groups according to the international photo-graphic classification system: Category 0 (C0) with no myopic retinal degenerative lesions, Category 1 (C1) with tessellated fundus, and Category 2 (C2) with diffuse chorioretinal atrophy. Peripapillary retinal thickness was assessed using swept-source optical coherence tomography (SS-OCT) B-scans. All data were analyzed with the SPSS software version 23.0 by one-way ANOVA test among three groups. Linear regression and pearson correlation analysis were used to determine the relationships among measurements. ResultsThe retinal thickness of the peripapillary was measured from the superior, nasal, inferior, and temporal directions around the optic disc. The superior, nasal, and inferior peripapillary retinal thickness in the C2 group decreased significantly in all three groups. The retinal thicknesses decreased significantly with the increase of AL in the superior, nasal, and inferior. The retinal thicknesses increased significantly with the increase of refractive diopter, except for the temporal sector. The retinal thickness decreased significantly with the increase of age in dry-type HM. There was no significant difference between peripapillary retinal thickness and the wide macular staphyloma. ConclusionsIndividuals in the C2 group had a thinner peripapillary retinal thickness than other groups, except for the temporal sector. The retinal thicknesses of the peripapillary decreased significantly with the increase of AL and increased significantly with the increase of refractive diopter, except for the temporal sector. With the increase of age, the retinal thickness of the peripapillary decreased significantly. Ophthalmologists and HM patients should pay attention to changes in the thickness of the peripapillary retina and the growth of age.

A Comparative Analysis of International Classification Systems to Predict the Risk of Collapse in Single-Level Osteoporotic Vertebral Fractures.

Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse. A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses. This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant's morphological, Genant's quantitative, Sugita 's, DGOU's, and AO Spine's classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant's quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association (p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up. The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings.

Toward an innovative function-oriented assessment methodology (FOAM) for evaluating the functional condition of buildings during the operation and maintenance phase

This paper introduces a foundational approach toward defining a Function-Oriented Assessment Methodology (FOAM) for evaluating the functional condition of buildings during the operation and maintenance phase. Although various national classification systems exist, a unified international system for organizing construction elements has not been widely adopted. To bridge this gap, the paper proposes adopting an international standard-based classification system for identifying objects within a function-oriented structure. Traditional inspections often focus on damage, overlooking the functional condition of construction elements. This research addresses these limitations with a comprehensive methodological approach tailored to assess functional condition. It employs a multiple-choice questionnaire adapted from international rating scales to ensure consistency and minimize subjectivity among inspectors. A case study validates the effectiveness of this strategic framework, demonstrating high consistency and accuracy in evaluating functional conditions. Overall, this research lays the groundwork for FOAM, offering a clear path for its broader application in the built environment.

Optimizing Integration with the Italian EHR: The Use of LOINC Codes.

According to the regulation "Decreto del Presidente del Consiglio dei Ministri" (DPCM) of September 29, 2015, n.178, the Logical Observation Identifiers Names and Codes (LOINC) system is included among the coding systems adopted in the Italian Electronic Health Record (EHR). As part of the Digital Health Solutions in Community Medicine (DHEAL-COM) project, one key goal is to categorize parameters using international classification systems. This enables the identification of appropriate Information and Communication Technology (ICT) solutions tailored to support people's health needs. Our objective is to incorporate LOINC codes for parameter categorization, thus anticipating the future use of EHR.

Classification of the Volume of Tumor Lesion of the Chest Wall as A Prerequisite for Planning Surgical Treatment

Tumors of the chest wall are a heterogenous group of neoplasms per nosology, clinical progression, and treatment methods. Primary tumors of this location, according to some authors, comprise between 1 and 5 %, and 60 % of them are malignant. Tumors of the chest wall can have not only various nosological forms but also varying volume, location, affect different structures of the chest wall which are determined during physical exam. Despite the progress in drug therapy, radical surgical intervention is a prerequisite for successful treatment of patients with malignant tumors of the chest wall. One of the most important prognostic factors is sufficient margin during chest wall resection. The international tumor classification system Tumor, Nodus and Metastasis (TNM) does not give a complete understanding of the volume of lesions and therefore does not allow to correctly plan resection volume and defect reconstruction based on its data.The article presents a classification of tumor volume of the chest wall proposed by the Sarcoma Research Association which allows to expand indications for surgical treatment and select the optimal type of defect reconstruction.

International Classification System for Ocular Complications of Anti-VEGF Agents in Clinical Trials

Complications associated with intravitreal anti-VEGF therapies are reported inconsistently in the literature, thus limiting an accurate evaluation and comparison of safety between studies. This study aimed to develop a standardized classification system for anti-VEGF ocular complications using the Delphi consensus process. Systematic review and Delphi consensus process. Twenty-five international retinal specialists participated in the Delphi consensus survey. A systematic literature search was conducted to identify complications of intravitreal anti-VEGF agent administration based on randomized controlled trials (RCTs) of anti-VEGF therapy. A comprehensive list of complications was derived from these studies, and this list was subjected to iterative Delphi consensus surveys involving international retinal specialists who voted on inclusion, exclusion, rephrasing, and addition of complications. Furthermore, surveys determined specifiers for the selected complications. This iterative process helped to refine the final classification system. The proportion of retinal specialists who choose to include or exclude complications associated with anti-VEGF administration. After screening 18 229 articles, 130 complications were categorized from 145 included RCTs. Participant consensus via the Delphi method resulted in the inclusion of 91 complications (70%) after 3 rounds. After incorporating further modifications made based on participant suggestions, such as rewording certain phrases and combining similar terms, 24 redundant complications were removed, leaving a total of 67 complications (52%) in the final list. A total of 14 complications (11%) met exclusion thresholds and were eliminated by participants across both rounds. All other remaining complications not meeting inclusion or exclusion thresholds also were excluded from the final classification system after the Delphi process terminated. In addition, 47 of 75 proposed complication specifiers (63%) were included based on participant agreement. Using the Delphi consensus process, a comprehensive, standardized classification system consisting of 67 ocular complications and 47 unique specifiers was established for intravitreal anti-VEGF agents in clinical trials. The adoption of this system in future trials could improve consistency and quality of adverse event reporting, potentially facilitating more accurate risk-benefit analyses. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

My assistive technology outcomes framework: rights-based outcome tools for consumers to ‘measure what matters’

ABSTRACT AT outcomes research is the systematic investigation of changes produced by AT in the lives of AT users and their environments. In contrast to focal outcome measures, My Assistive Technology Outcomes Framework (MyATOF) envisions an alternative starting point, co-designing a holistic and evidence-based set of outcome dimensions enabling AT users to quantify their own outcomes. International classification systems, research evidence, regulatory and service delivery frameworks underpin six optional tools: supports, outcomes, costs, rights, service delivery pathway and customer experience. Designed to empower the consumer-as-researcher and self-advocate, MyATOF has the potential to fill an identified gap in policy-relevant, consumer-focussed and consumer-directed outcome measurement in Australia and internationally. This paper presents the need for consumer-focussed measurement and articulates the conceptual foundations of MyATOF. The iterative development and results of MyATOF use-cases collected to date are presented. The paper concludes with next steps in using the Framework internationally, as well as its future development.

Treatment Outcomes of Retinoblastoma in Children Less than 6 Months of Age

Treatment Outcomes of Retinoblastoma in Children Less than 6 Months of Age

Role of maceral groups in coal beneficiation: A short review

Macerals are the basic constituents of coal that can be distinguished and identified under the microscope. Depending on the difference in optical properties, the macerals are divided into four maceral groups, including liptinite, vitrinite, huminite and inertinite. These maceral groups not only affect coal mining and utilization but also play different roles in coal beneficiation. According to the different properties of maceral groups, they can be separated (or enriched) to provide high-quality raw materials for the coal industry. This review briefly introduces the international maceral classification system and reviews in detail the role of maceral groups in coal beneficiation combined with their properties.

Classification of acid sulfate soils and soil materials in Finland and Sweden: Re-introduction of para-acid sulfate soils

Established international soil classification systems have not properly accommodated acid sulfate soils (ASS) and soil materials in Finland and Sweden because: (1) in these soils some diagnostic ASS properties are too deep to meet the depth requirements, and (2) there is a lack of defined diagnostic soil classification criteria for acidic and potentially acidic soil materials that do not completely fulfill the diagnostic pH-criterion of pH < 4.0. In this paper, two new ASS materials are introduced with the prefix “para” for parasulfuric material (oxidized material) and parahypersulfidic material (reduced material). These materials have diagnostic pH-criteria of pH 4.0–4.5 and 3.0–3.5 (field-pH for parasulfuric material and incubation-pH for parahypersulfidic material) for mineral and organic soil materials (here defined as > 20% organic matter; peat and gyttja), respectively. The term “para-acid sulfate soil (para-ASS) material” is introduced for soil materials which may have a considerable environmental impact due to mobilization of acidity and dissolved metals. Because organic acids may lower pH to values below the established pH-value of < 4.0 for ASS materials, a pH of < 3.0 is used in the Finnish-Swedish ASS classification for organic soil materials. These changes and new additions to existing diagnostic ASS materials have consequently also led to a slight modification of the required field-pH values of the existing terms “hypersulfidic material” and “sulfuric material”. The Finnish-Swedish ASS classification further includes a systematic way for classification of the entire soil profile and no depth requirements for diagnostic ASS materials are present; what matters is the current or potential environmental impact that the soil has or may have. It is proposed that the Finnish-Swedish ASS classification may serve as a framework for establishing a unified ASS classification globally and that the new diagnostic ASS materials are included in relevant international soil classification systems.

Cross-national analysis of the prevalence of prolonged grief disorder

BackgroundProlonged grief disorder (PGD) is now included as a diagnosis in international classification systems. Most research on PGD is based on Western populations, but first data from non-Western countries have recently become available. Little is still known about country-related effects on PGD's prevalence. ObjectiveDetermining possible causes of variations in the prevalence of PGD as defined by DSM-5-TR and ICD-11 within and between countries. MethodsWe retrieved data from 24 prevalence studies, the World Bank and the 2022 World Risk Report. Negative binomial regressions were used to explore methodological, loss-related and country context characteristics as predictors of PGD. The average rate of PGD was calculated using random effects models. ResultsThe included studies comprised 34 samples from 16 countries (20,347 participants). Non-probability sampling and older mean age of the sample as well as lower country vulnerability were associated with higher PGD rates. The average PGD prevalence was 13 % (95 % CI [11, 22]), varying from 5 % (95 % CI [3, 11]) in probability to 16 % (95 % CI [13, 25]) in non-probability samples. LimitationsSamples from Europe and North America were overrepresented. For about half of the countries, data were available from only one sample. ConclusionsWhile confirming the importance of studies' methodological quality, the results show that PGD is of public health relevance around the world, but especially common in less vulnerabled countries with better access to daily necessities and healthcare services, highlighting sociocultural impacts on grief processing. Further investigations of cross-national differences are needed.

Psychometric Evaluation of the A-NKS: A Diagnostic Instrument to Assess Impairment of Activities of Daily Living in Mild and Major Neurocognitive Disorder According to DSM-5.

Activities of daily living (ADL) functioning are important in the diagnosis of neurocognitive disorders (NCD), yet no standardized and validated instrument exist based on international classification systems. We aimed to psychometrically evaluate the differentiated assessment of ADL and instrumental ADL (IADL) impairments due to NCD according to DSM-5 criteria (Instrument für die Erfassung von Alltagsbeeinträchtigungen bei Neurokognitiven Störungen; A-NKS). We conducted a pilot study involving 92 participant-informant dyads of participants with mild or major NCDs, cognitively healthy individuals, and an informant, to test acceptability, internal consistency, and convergent validity with similar measures. Both A-NKS versions demonstrated excellent internal consistency (α= 0.95 -0.99) and correlate with other instrumental ADL instruments (participant [informant]: Barthel Index: rs = -0.26, p≤0.05 [rs = -0.30, p≤0.01]; Amsterdam IADL: rs = 0.59, p≤0.01 [rs = 0.48, p≤0.01]; SIDAM ADL: rs = 0.46, p≤0.001 [rs = 0.47, p≤0.001]). Additionally, there are correlations with the scale autonomy of the WHOQOL-OLD (rs = -0.50, p≤0.001 [rs = -0.37, p≤0.001]) and physical, as well as cognitive activities (rs = -0.39, p≤0.001 [rs = -0.50, p≤0.001]). They were well-accepted by participants and informants. The A-NKS is an instrument with acceptable psychometric properties to assess ADL due to neurodegenerative decline in healthy individuals, and those with mild or major NCD. Further research is needed to confirm reliability and validity and investigate the factor structure.

РЕГУЛЯТОРНІ РЕАЛІЇЇ ОСУЧАСНЕННЯ МІЖДИСЦИПЛІНАРНИХ ЗВ’ЯЗКІВ У СИСТЕМІ ВИЩОЇ ОСВІТИ ПРИ НАБУТТІ ЕКОНОМІЧНОЇ ОСВІТИ В ГАЛУЗЕВИХ ЗВО

In Ukraine, as part of the implementation of the higher education system, the training of students in higher education institutions is carried out on the basis of the List of Fields of Knowledge and Specialties in which university students are trained. This document is a framework regulatory document and over time has been amended and supplemented in response to the current challenges of the modern higher education system. Currently, the Ministry of Education and Science of Ukraine has prepared for public discussion a draft resolution of the Cabinet of Ministers of Ukraine “On Approval of the List of Fields of Knowledge and Specialties for Training of Higher Education Students”. The structure and number of the fields of knowledge and specialties is close to the list of fields of the International Standard Classification of Education; and the document is another step towards the transition to common statistical standards and classification systems to harmonize and ensure the comparability of government statistics with such international standards and recommendations as the UN international standard classification systems. The article analyzes the regulatory elements of the modernization of interdisciplinary relations in the system of higher education using the example of economic education in industry-specific higher education institutions by means of a comparative analysis. The article is based on the interdisciplinary links of economic subjects with the philosophy and humanities and special technical subjects taught in industry-specific universities. In the context of this direction, the author’s view on the interdisciplinary relations of disciplines in educational and professional programs as a certain meaningful scientific environment, in the context of “smaller” and “wider” philosophical circles in terms of the actual state and with the aim of assessing further progressive development based on the potential state, is represented. The author's view of interdisciplinary relations through the philosophical circles of the scientific environment became the basis for the introduction of the idea of for mathematical calculations of quantitative and qualitative assessments of the level of interdisciplinarity using such mathematical apparatus as a Venn diagram, and using a Euler’s circle for the visual representation of certain interdisciplinary relations. Based on the results of the calculations and a developed actual model of interdisciplinary relations in the educational and professional program, it is proposed to further compare the model with the reference standard of the balanced model of the interdisciplinarity system in the process of meaningful construction of the educational program in the specialty as a scientific environment.

Exploring body morphology, sacral skin microclimate and pressure injury development and risk among patients admitted to an intensive care unit: A prospective, observational study

ObjectiveTo determine the association between body morphology, sacral skin microclimate and their impact on the development and risk of pressure injuries among patients in an intensive care unit. MethodologyA prospective observational exploratory study was conducted over 30 weeks. Repeat study observations occurred multiple times a week for 28 days or until discharge. Participant inclusion criteria were ≥ 18 years of age, expected intensive care length of stay > 24 h and intact skin over the sacrum region. SettingThe study was conducted in a 36-bed intensive care unit of a major metropolitan public hospital in Queensland, Australia. Outcome measuresPressure injuries were staged and independently verified according to the international pressure injury classification system. Pressure injury risk was determined by the Braden scale score and subepidermal oedema, using a subepidermal moisture scanner at the sacrum. ResultsOf the 93 participants recruited, an inverted triangle body shape (p =.049), a BMI > 25 kg/m2 (p =.008), a standard foam mattress type (p =.017) and increased length of stay (p <.001) were associated with an increased pressure injury risk according to subepidermal oedema. Participants with increased sacral skin temperature (p <.001), mechanical ventilation (p <.001), vasoactive drugs administered (p =.003), increased sequential organ failure assessment score (p =.047), neurovascular diagnosis (p =.031) and increased length of stay (p =.027) were associated with increased pressure injury risk according to the Braden scale score. ConclusionBody morphology and skin microclimate are associated with pressure injury risk during critical illness. Implications for Clinical PracticeSubepidermal oedema was associated with a patient’s shape, body mass index and mattress type, factors that directly influence the pressure loading and the skin, whereas the Braden scale was associated with sacral temperature and clinical measures of critical illness. Consideration of body morphology and skin microclimate in pressure injury risk assessment could lead to more specific prevention strategies targeting high risk patients.

Psychodeontological prerogatives related to the stigma of patients affected by mental disorders

The American Psychiatric Association defines mental illnesses as alterations in the cognitive, emotional or behavioral sphere (or a combination of these domains), which lead to suffering and/or problems in the person's social, professional or relational interaction skills. Given the range of possible symptoms, when talking about mental illnesses, reference should always be made to a standardized classification system, i.e. a list of disorders recognized to date, accompanied by their description and lists of symptoms and essential criteria for diagnosis. Currently, the most widely used manual in the world is the DSM (Diagnostic and Statistical Manual of Mental Disorders), published by the American Psychiatric Association, whose structure follows a multiaxial system. Other international norms or classification systems include the International Statistical Classification of Diseases and Related Health Problems (ICD), which is often referred to by the WHO in mental health action plans, defining "mental disorders" as the range of disorders that falls under the ICD-10 classification. Within the given classifications, we can find disorders of different severities, with significant differences both in terms of the degree of suffering and in terms of the effects on the person's capacity for social interaction. However, the present paper does not aim to analyze clinical problems related to mental illnesses, but to address the state of care of people suffering from such illnesses in our country. In particular, we are motivated by the need to examine, from a bioethical point of view, critical issues arising from various studies of the current state of psychiatric care, critical issues affecting the lives of people with mental illness and their families, and which are strongly denounced to the institutions by the scientific societies.

Should we enlarge the indication for kidney biopsy in patients with diabetes? The pro part.

Diabetic nephropathy (DN) and non-diabetic renal diseases (NDRD) represent intricate challenges in diagnosis and treatment within the context of the global diabetes epidemic. As the prevalence of diabetes continues to escalate, effective management of renal complications becomes paramount. Recent advancements in comprehending the multifaceted nature of renal damage, fueled by insights from histopathological investigations, offer unprecedented prospects for refining diagnostic strategies and customizing therapeutic interventions. Renal biopsies have emerged as indispensable tools for unraveling the diverse phenotypes of renal damage in diabetes. The pioneering study by Mazzucco identified three classes of renal damage in type 2 diabetes patients: classical diabetic glomerulosclerosis (DN), vascular and ischemic glomerular changes (NDRD), and other glomerulonephritides in the presence (DN+NDRD, mixed forms) or absence of DN (NDRD). The prevalence of these classes varies widely in published studies, influenced by factors such as ethnicity, geography and selection criteria for renal biopsy. Moreover, the international Renal Pathology Society consensus classification system has stratified the classical diabetic nephropathy into progressive categories of renal impairment, a breakthrough that aids in prognostication. Histopathological scrutiny, particularly the intricate correlation between glomerular and tubulointerstitial lesions, contributes profoundly to enhancing our grasp of the phenotype's heterogeneity. This amplified comprehension holds the potential to steer personalized treatment strategies. Cutting-edge interventions, encompassing sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists and anti-endothelin receptor agents, are broadening the arsenal against renal injury in diabetes. When combined with the profound insights garnered from histopathological, omics, imaging and clinical data, these therapeutic avenues promise a transformative shift towards precision-driven care paradigms. Collaborative efforts uniting researchers, clinicians and patients are indispensable for propelling our knowledge of diabetic renal damage and ameliorating patient outcomes. The fusion of histopathological, omics and imaging findings into clinical decision-making harbors the potential to customize interventions and optimize care for individuals grappling with diabetes-associated renal complications. Furthermore, groundbreaking initiatives like the iBeat Study within the BEAt-DKD (Biomarker Enterprise to Attack Diabetic Kidney Disease) project (https://www.beat-dkd.eu/), elucidating distinct phenotypes of renal damage within diabetes, underscore the imperative necessity of integrating histopathological data into the broader framework of diabetic renal management.

Social and environmental features in domestic and international minerals resources classification systems

This paper is aimed at a comparison of Ukrainian and international resource classification systems’ fundamental features. As a result, the most common and different features were outlined. The importance of accounting for the social and environmental viability of projects is determined. This study highlights the significance of the harmonization of domestic classification with international standards.

Innovative approaches to analysing aged care falls incident data: international classification forpatient safety andcorrespondence analysis.

Falls in residential aged care facilities (RACFs) are common and can have significant health consequences. Understanding how and why falls occur in RACFs is an essential step to design targeted fall prevention and intervention programmes; however, little is known about falls' mechanisms in RACFs. This study aims to use international incident classification systems and novel analysis techniques to describe factors that contribute to falls requiring hospitalization in RACFs. Retrospective data of falls assessed by nurses as requiring hospitalization from 429 residents in 22 Australian RACFs in 2019 were used. Data were reviewed using a modified version of the International Classification for Patient Safety (ICPS), which categorizes patient safety into incident types and contributing factors using a three-tiered structure. The ICPS codes were summarized using the descriptive statistics. The association between assigned ICPS codes were analysed using correspondence analysis. Six hundred and three falls assessed as requiring hospitalization were classified into 659 incident types, with the most common incident type being 'patient incidents' (injury sustained/adverse effect in the health care system) (603, 91.5%) at Level 1, 'falls' (601, 91.2%) at Level 2, and 'falls involving bedrooms' (214, 32.5%) at Level 3. The 603 falls had 1082 contributing factors, with the most common contributing factor being 'patient factors' (events affected by factors associated with the patient) (982, 90.8%) at Level 1, 'patient not elsewhere classified' (characteristics of the patient contributed to the incident not classified elsewhere) (571, 52.8%) at Level 2, and 'loss of balance' (361, 33.4%) at Level 3. In a correspondence analysis, three dimensions were responsible for 81.2% of the variation in falls incidents and environmental and organizational factors were important factors contributing to falls. The application of the ICPS demonstrated that personal factors (e.g. pre-existing physical and psychological health or impairment) were the most common contributing factors to falls assessed as requiring hospitalization, while the correspondence analysis highlighted the role of environmental and organizational factors. The results signal the need for more research into multifactorial falls prevention interventions in RACFs.

한국의 비영리 공익활동 분류체계 개선 연구

This study was conducted to identify the problems of various public interest activity classification systems currently in use in Korea and to propose a rational improvement plan for the classification system of nonprofit public interest activities in Korea. For the research, we analyzed major domestic and international public interest activity classification systems in terms of analysis units, classification criteria, and response rules. We reviewed the advantages and disadvantages according to the classification system evaluation criteria. The public interest activity classification system proposed in this study takes 'public interest activities' performed at the level of non-profit organizations or individuals as the unit of analysis. The first essential classification criterion is the 'main activity and service area' (10 items), and the second optional classification criteria are 'main beneficiaries' (14 items), 'main spatial range' (4 items), 'main method of performance' (6 items), 'online activity status' (3 items), and 'connection with official organizations' (2 items). The classification system of this study has strengths in terms of logical consistency, exclusivity between classification items, economy, and rich combinability.

Can Brain-Derived Neurotrophic Factor Be Considered a Biomarker for Bipolar Disorder? An Analysis of the Current Evidence.

Brain-derived neurotrophic factor (BDNF) plays a key role in brain development, contributing to neuronal survival and neuroplasticity. Previous works have found that BDNF is involved in several neurological or psychiatric diseases. In this review, we aimed to collect all available data on BDNF and bipolar disorder (BD) and assess if BDNF could be considered a biomarker for BD. We searched the most relevant medical databases and included studies reporting original data on BDNF circulating levels or Val66Met polymorphism. Only articles including a direct comparison with healthy controls (HC) and patients diagnosed with BD according to international classification systems were included. Of the 2430 identified articles, 29 were included in the present review. Results of the present review show a reduction in BDNF circulating levels during acute phases of BD compared to HC, which increase after effective therapy of the disorders. The Val66Met polymorphism was related to features usually associated with worse outcomes. High heterogeneity has been observed regarding sample size, clinical differences of included patients, and data analysis approaches, reducing comparisons among studies. Although more studies are needed, BDNF seems to be a promising biomarker for BD.